If you have a debilitating fear of being seen negatively by others and humiliated in public, you may have social anxiety disorder, also known as social phobia. Social anxiety disorder can be thought of as extreme shyness. In severe cases, social situations are avoided altogether. Performance anxiety (better known as stage fright) is the most common type of social phobia.
Family Therapy is a type of group therapy that includes the patient's family to help them improve communication and develop better skills for solving conflicts. This therapy is useful if the family is contributing to the patient's anxiety. During this short-term therapy, the patient's family learns how not to make the anxiety symptoms worse and to better understand the patient. The length of treatment varies depending on the severity of symptoms.

I’ve had a lot of these symptoms and I know I also have depression. These anxiety attack’s come at the worst of times, when I work and I can’t get my mind focused back into what I need to do. I’m only 19 years old, but I’ve been to hell & back. Serving in the U.S.Marines to now, back home not doing anything I love after I got discharged. I feel lost and I haven’t got my life back together yet. I don’t have anyone to depend on besides my brother who is a Marine now, stationed 1000 miles away. I haven’t been able to establish myself well, since. I do have a wonderful girlfriend I love dearly and we have been together 2-years, traveling with me and moving near me. I’ve come home and things just feel like they’re slipping away. I was trained to not stress and be calm in the worst situations. But, even as a Marine, things can get very hard and wear on my mind. I thought nothing would be worse than Parris Island, but I am wrong. Life has been beating me down. I lost my car because someone sold me a stolen car and I feel like I’ve lost motivation to do my job; Walking and hitching rides to work to make best I can do. If there’s anyone that’s older that can give me some advice, that would be great. Because I don’t have a lot of people, my brother is not here, and I just need something. I want to do nothing but great things in this life. It’s just been hard to deal with lately and I’m losing hope. These anxiety attacks are slowly killing me. It’s every second of every-single-day.
Exposure therapy for panic disorder allows you to experience the physical sensations of panic in a safe and controlled environment, giving you the opportunity to learn healthier ways of coping. You may be asked to hyperventilate, shake your head from side to side, or hold your breath. These different exercises cause sensations similar to the symptoms of panic. With each exposure, you become less afraid of these internal bodily sensations and feel a greater sense of control over your panic.
Anxiety disorders can often be addressed successfully with a combination of therapy and medication. For therapy, patients may undergo psychotherapy or cognitive behavioral therapy, in which they learn to change how they respond to situations that induce anxiety. For medications, clinicians may, for limited periods of time, prescribe antidepressants such as selective serotonin reuptake inhibitors or tricyclics, tranquilizers such as benzodiazepines; they may also prescribe beta blockers for specific events. Different strategies can also help people who experience feelings of anxiety but the severity of which falls below the clinical threshold for diagnosis. Habits such as exercising, sleeping well, and limiting the amount of caffeine and alcohol consumed can prove helpful. Strategies such as taking deep breaths, acknowledging limits to fully controlling situations, pushing back against anxious or irrational thoughts, and observing the circumstances that tend to produce anxiety are proven to reduce anxiety by helping people feel better prepared in the future.
A condition in which parting with objects (e.g., household items or personal possessions) causes significant distress. In addition, many individuals continuously acquire new things and experience distress if they are not able to do so. The inability to discard possessions can make living spaces nearly unusable. Relatedly, the cluttered living space can interfere with the performance of daily tasks, such as personal hygiene, cooking, and sleeping (e.g., the shower is full of stuff, the bed is covered with clutter).
Seeing a friend or loved one suffering a panic attack can be frightening. Their breathing may become abnormally fast and shallow, they could become dizzy or light-headed, tremble, sweat, feel nauseous, or think they’re having a heart attack. No matter how irrational you think their panicked response to a situation is, it’s important to remember that the danger seems very real to your loved one. Simply telling them to calm down or minimizing their fear won’t help. But by helping your loved one ride out a panic attack, you can help them feel less fearful of any future attacks.

Dr. John Grohol is the founder, Editor-in-Chief & CEO of Psych Central. He is an author, researcher and expert in mental health online, and has been writing about online behavior, mental health and psychology issues -- as well as the intersection of technology and human behavior -- since 1992. Dr. Grohol sits on the editorial board of the journal Computers in Human Behavior and is a founding board member and treasurer of the Society for Participatory Medicine. He writes regularly and extensively on mental health concerns, the intersection of technology and psychology, and advocating for greater acceptance of the importance and value of mental health in today's society. You can learn more about Dr. John Grohol here.


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Cognitive Behavioral Therapy (CBT) is an example of one type of psychotherapy that can help people with anxiety disorders. It teaches people different ways of thinking, behaving, and reacting to anxiety-producing and fearful objects and situations. CBT can also help people learn and practice social skills, which is vital for treating social anxiety disorder.


Yes, anxiety attacks and their signs and symptoms can feel awful, intense, and threatening. But they aren’t harmful. They pass when the anxiety attack subsides. Getting the right information, help, and support is the best way to treat anxiety attacks and their signs and symptoms. We provide more detailed information in the Recovery Support area of our website.
More than shyness, this disorder causes intense fear about social interaction, often driven by irrational worries about humiliation (e.g. saying something stupid or not knowing what to say). Someone with social anxiety disorder may not take part in conversations, contribute to class discussions or offer their ideas, and may become isolated. Panic attacks are a common reaction to anticipated or forced social interaction.

Another important prevention strategy for anxiety is to incorporate exercise into your daily activities. Exercise has been shown to decrease stress hormones that influence anxiety and also improve overall mood. Exercise can also help you disengage from worry and stress and focus on the current task of exercising. Exercises such as light jogging or brisk walking that can be incorporated into your daily activities can help reduce the impact of anxiety when it occurs.


Antidepressants are medications used to treat symptoms of depression but can also used to treat anxiety symptoms as well. In particular, selective serotonin reuptake inhibitors (SSRIs) and selective norepinephrine reuptake inhibitors (SNRIs) are the primary class of antidepressant used to treat anxiety. SSRIs commonly used to treat anxiety are escitalopram (Lexapro) and paroxetine (Paxil, Pexeva). SNRI medications used to treat anxiety include duloxetine (Cymbalta), venlafaxine (Effexor XR).

Other research suggests that social structures that contribute to inequality, such as lower wages, may play a part. In a study published in January 2016 in the journal Social Science and Medicine, Columbia epidemiologists reviewed data on wages and mood disorders, and noted that, at least in their data set, when a woman's pay rose higher than a man's, the odds of her having both generalized anxiety disorder and major depression decreased. (10)


Antidepressants are used to treat depression, but they can also be helpful for treating anxiety disorders. They may help improve the way your brain uses certain chemicals that control mood or stress. You may need to try several different antidepressant medicines before finding the one that improves your symptoms and has manageable side effects. A medication that has helped you or a close family member in the past will often be considered.

Many medical conditions can cause anxiety. This includes conditions that affect the ability to breathe, like COPD and asthma, and the difficulty in breathing that often occurs near death.[67][68][69] Conditions that cause abdominal pain or chest pain can cause anxiety and may in some cases be a somatization of anxiety;[70][71] the same is true for some sexual dysfunctions.[72][73] Conditions that affect the face or the skin can cause social anxiety especially among adolescents,[74] and developmental disabilities often lead to social anxiety for children as well.[75] Life-threatening conditions like cancer also cause anxiety.[76]

A key component to the prevention of anxiety is awareness. Learning to recognize your anxious thinking patterns when they arise can help you manage and reduce them quickly. Awareness of anxiety begins with trying to identify the cause and/or trigger of anxiety and gaining an understanding of how it affects your mood and behaviors. Is it that your boss recently gave you negative feedback at work and you are worried each day that you are not doing well enough for their standards? Is it that you waited until the last minute to study for a test and are feeling anxious that you will not perform well? Awareness of the source of your anxiety is the first step to finding out the best way to relieve it.

There has been recent interest in using psychoactive substances in conjunction with psychotherapy; the two that have received increased attention have been cannabis (marijuana) and methylenedioxymethamfetamine (MDMA, known as ecstasy or molly). These drugs are somewhat controversial, given that they also have psychoactive, i.e. "feeling high" effects. However, with increasing legalization of marijuana it is important to address whether these substances could be used to alleviate clinical symptoms of anxiety. While there have been only a few randomized clinical trials for these drugs, certain forms of cannabis have demonstrated positive effects on anxiety. Specifically, cannabidiol, a component of cannabis has been effective for Social Anxiety Disoder, and tetrahydrocannabinol (THC) has helped PTSD patients. However, the plant form of cannabis has not shown great efficacy and has potential to worsen symptoms, so should be used with caution and only under supervision of a provider. MDMA has shown some positive effects for PTSD, but should only be used as an adjunct to psychotherapy, again under clinical care.

The philosopher Søren Kierkegaard, in The Concept of Anxiety (1844), described anxiety or dread associated with the "dizziness of freedom" and suggested the possibility for positive resolution of anxiety through the self-conscious exercise of responsibility and choosing. In Art and Artist (1932), the psychologist Otto Rank wrote that the psychological trauma of birth was the pre-eminent human symbol of existential anxiety and encompasses the creative person's simultaneous fear of – and desire for – separation, individuation, and differentiation.
Although we don’t yet completely understand what causes Panic Disorder, we do know that genes play a large role because it’s very common for the immediate family members of someone with Panic Disorder to also have Panic Disorder. Research also suggests that experiencing really stressful events (e.g., major loss or abuse) might play a role in the development of Panic Disorder. And in certain people, marijuana appears to trigger the start of Panic Disorder, suggesting that the family members of someone with Panic Disorder or other anxiety disorders should probably stay away from this (and other) drugs.
As is the case the more generalized forms of social anxiety, intergroup anxiety has behavioral, cognitive, and affective effects. For instance, increases in schematic processing and simplified information processing can occur when anxiety is high. Indeed, such is consistent with related work on attentional bias in implicit memory.[39][40][41] Additionally recent research has found that implicit racial evaluations (i.e. automatic prejudiced attitudes) can be amplified during intergroup interaction.[42] Negative experiences have been illustrated in producing not only negative expectations, but also avoidant, or antagonistic, behavior such as hostility.[43] Furthermore, when compared to anxiety levels and cognitive effort (e.g., impression management and self-presentation) in intragroup contexts, levels and depletion of resources may be exacerbated in the intergroup situation.
Generally, anxiety arises first, often during childhood. Evidence suggests that both biology and environment can contribute to the disorder. Some people may have a genetic predisposition to anxiety; however, even so, development of the condition is not inevitable. Early traumatic experiences can also reset the body’s normal fear-processing system so that it is hyper-reactive.
ACT is a type of CBT that encourages patients to again in positive behaviors even in the presence of negative thoughts and behaviors. The goal is to improve daily functioning despire having the disorder. It is particularly useful for treatment-resistant Generalized Anxiety Disorder and Depression. The length of treatment varies depending on the severity of symptoms.
Not everyone who worries a lot has an anxiety disorder. You may be anxious because of an overly demanding schedule, lack of exercise or sleep, pressure at home or work, or even from too much caffeine. The bottom line is that if your lifestyle is unhealthy and stressful, you’re more likely to feel anxious—whether or not you actually have an anxiety disorder. These tips can help to lower anxiety and manage symptoms of an anxiety disorder:

Women are more than two times as likely as men to be diagnosed with an anxiety disorder. (6) It’s not clear why this is the case, but researchers have theorized that it may be due to a combination of social and biological factors. Scientists are still investigating the complex role that sex plays in brain chemistry, but some research suggests that in women, the amygdala, which is the part of the brain responsible for processing potential threats, may be more sensitive to negative stimuli and may hold on to the memory of it longer. (7) 
The buildup phase of a panic attack is the most important phase, because it is when you can prevent it. If you are under chronic stress, you become worn down and have no reserve left. Anything can push you over the edge. But if you regularly reduce your stress through a combination of cognitive behavioral therapy and mind-body relaxation, you will have enough reserve left to handle life’s surprises.

You can learn more about this in the Recovery Support area of our website. Our support area contains a wealth of self-help information on how to treat anxiety disorder, including anxiety attacks. Many find it to be their “one stop” destination for anxiety disorder help. You can click here for more information about our Recovery Support area membership options.

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